The long term objective for this program of research is to develop a causal model which explains worker's use of protective equipment and will guide the development of effective nursing interventions. This project will test a proposed causal model, the Health Promotion Model (HPM) model, identify and test a nursing intervention to increase workers' use of hearing protection equipment. Consistent use of hearing protection prevents noise-induced hearing loss, an irreversible impairment with very significant monetary and personal costs. The specific aims for the project are: 1) Test the ability of the HPM to explain variance in workers' use of hearing protection. 2) Determine relationship of other health behaviors practiced by workers to their use of hearing protection. 3) Determine congruence of multiple indicators of use of hearing protection; worker's self-reports, observations of workers, and supervisors' perception of workers' use regarding use of hearing protection. 4) Assess feasibility of alternatives to the use of workers' self-reported data regarding use of hearing protection. 5) Using the results from the testing of the HPM, design and test a nursing intervention based upon the dominant parsimonious set of predictors. These aims will be accomplished through the three subprojects in this research project. The first uses a correlational design to assess relationships between components of the HPM and health behaviors with workers' use of hearing protection (Specific Aims #1 ad 2). The second subproject, through its use of multiple indicators to measure workers' use of hearing protection (self-report, supervisor-report and observations) determines congruence of measures, and guides the design of future studies (Specific Aims #3 & 4). The third subproject uses an experimental pretest-post-test control group design to test the effectiveness of a nursing intervention (Specific Aim #5). The specific design and methods for the intervention study will be guided by results of the first tow subprojects. Benefits to be derived from completion of the proposed study are: 1) Provision of empirically tested information to aid nurses in developing their interventions to promote use of hearing protection. Reducing the incidence of noise-induced hearing loss will save significant dollars and prevent the negative effects of hearing loss on quality of life. 2) Testing the HPM with a different population and different health behavior than tested previously. This will contribute to the refinement of the HPM, providing useful information regarding a Model important to nursing practice. 3) contribution to nursing's science base by testing the HPM, and by the beginning development of a causal model to explain the variance in workers' use of hearing protection.